Inflammatory breast cancer (IBC) is a rare subset of invasive breast cancers comprising about 1%. A report 15 years ago by Paul Levine from Tunisia suggested that women in that country had a higher incidence of IBC and that these patients had a very poor survival. My interests are in determining the molecular features of that group of IBC patients. Approximately 100 tissue blocks have been obtained from the Tunisian group. We will be evaluating the histology and each tumor for p53, erbB2, KI67, ER, PR, VEGF165, CD31, and other molecular markers. The results will be correlated with patient outcome. I have an interest in the vascular endothelial growth factors because in IBC extensive lymphovascular invasion is seen. One report suggested that VEGFC and D would be more common in IBC. We will evaluate this if the antibodies are available. Next, we are designing a pilot trial in Stage III and IV IBC patients. This trial will evaluate the administration of anti-VEGF for three weeks prior to chemotherapy. During this time, multiple biopsies will be done and evaluated for endothelial apoptosis, endothelial proliferation, and VEGF by immunohistochemistry. Also dynamic MRI imaging will be done at several time points to see if this modality can be used to determine efficacy of anti-VEGF. After the initial three week period, patients will be treated with conventional chemotherapy, radiation, and surgery followed by tamoxifen if estrogen receptor positive. An attempt will be made to correlate changes in the molecular markers with time to progression.